Individual provider Active NPI

Jennifer Congleton, CSW

  • Clinical Social Worker
  • Winchester, KY
National Provider Identifier
1124497185
Registry record updated Sep 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7430 Issued in KY
Practice address
247 Cross Brook LN
Winchester, KY 40391-8564
Phone
(859) 595-3695
NPI assigned
Sep 21, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 7430 KY Primary

Addresses

Primary practice location

247 Cross Brook LN
Winchester, KY 40391-8564

Mailing address

247 Cross Brook LN
Winchester, KY 40391-8564
Phone (859) 595-3695

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
7430KYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442793600000",
    "number": "1124497185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "247 CROSS BROOK LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918564",
            "telephone_number": "859-595-3695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "247 CROSS BROOK LN",
            "city": "WINCHESTER",
            "state": "KY",
            "postal_code": "403918564",
            "telephone_number": "859-595-3695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONGLETON",
        "first_name": "JENNIFER",
        "credential": "CSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-21",
        "last_updated": "2015-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KY",
            "license": "7430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.